Name

Email Address

Program or Sessions I'm Interested In Program or Sessions I'm Interested In RECONNECT Yoga + Movement Coaching Program Ongoing Private Yoga + Movement Session Private Group Session I'm not sure! I need help choosing!

Please describe any yoga, exercise, sports, or movement practices you do now.

Do you have a mindfulness or meditation practice? If so, please describe it briefly.

What exactly are you struggling with?

What are the top three goals you'd like to achieve by working with Robin?

What do you feel you need the most help with right now in your life and/or yoga + movement practice. Check all that apply. What do you feel you need the most help with right now in your life and/or yoga + movement practice. Check all that apply. Building strength Decreasing physical pain Increasing mobility Better balance Learning to modify postures to fit YOUR body due to injury, limitation, etc. Relaxation and stress relief Increasing focus Being a kinder, more patient, more compassionate person Complementing other sports/activities you do Accountability to actually practice and/or challenge yourself Develop a home practice that is consistent

Any other comments for Robin